Background As delayed family building is common among physicians, the goal of this study was to evaluate childbearing plans, anxiety related to future fertility, and interest in fertility education among medical students. Methods Using convenience and snowball sampling methods, an electronic REDCap survey was distributed via social media and group messaging applications to medical students enrolled in medical schools across the United States. Answers were collected, and analysis of the descriptive statistics was performed. Results The survey was completed by 175 participants, 72% of which were female (assigned at birth). The mean (± SD) age of participants was 24.9 ± 1.9 years. Of all participants, 78.3% desire to have children and 65.1% of these individuals plan to delay childbearing. On average, the planned age of first pregnancy is 31.0 ± 2.3 years. “Lack of time” was the greatest influence on decision regarding timing of childbearing. Of all respondents, 58.9% reported at least some anxiety related to future fertility. When females and males were compared, significantly more females (73.8%) versus males (20.4%) reported worrying about future fertility (p < 0.001). Participants reported that greater knowledge about infertility and potential treatments would help ease fertility related anxiety, and 66.9% of respondents showed interest in learning about how things such as age and lifestyle can impact fertility, preferably through medical curricula, videos, and podcasts. Conclusion A majority of the medical students in this cohort intend to have children and most plan to delay childbearing. A large percentage of female medical students reported anxiety related to future fertility, but many students showed interest in receiving fertility education. This study highlights an opportunity for medical school educators to incorporate targeted fertility education into their curriculum with the intention of decreasing anxiety and improving future reproductive success.
Objective To describe the experiences of three women with blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) who desired to pursue planned oocyte cryopreservation. Design Case series. Setting An academic institution and a private clinic. Patient(s) Three nulligravid women aged 23, 25, and 34 years who desired to pursue planned oocyte cryopreservation. Two women had BPES diagnosed when they were infants and one had BPES diagnosed after presenting to discuss oocyte cryopreservation. Intervention(s) All three women underwent ovarian stimulation. One woman underwent three oocyte retrievals. Main Outcomes Measure(s) Vitrification of metaphase II oocytes. Result(s) One woman had a total of eight metaphase II oocytes vitrified. In addition, she underwent genetic testing that confirmed type 1 BPES. The other two women, who had BPES diagnosed when they were newborns, each underwent two cycles of ovarian stimulation. Neither of these two women responded to ovarian stimulation and both cycles were cancelled before oocyte retrieval. Conclusion(s) BPES is a rare condition that can lead to primary ovarian insufficiency. Early identification of this condition is important to allow for timely reproductive counseling so that oocyte cryopreservation can be offered at a young age before oocyte depletion. Careful counseling is critical for these patients, because this case series demonstrated that not all women with BPES will respond to stimulation. Further, outcomes with cryopreserved oocytes have not yet been described in women with BPES.
OBJECTIVE: Disproportionate publications and citations by gender limit academic productivity and promotion to leadership positions, propagating existing gender disparities within the field of medicine. We sought to identify gender differences in publications and citations in the reproductive medicine literature.MATERIALS AND METHODS: Bibliometric data from articles published between 2008 and 2017 in two high impact REI journals were drawn from Web of Science and Scopus. Information was gathered on author gender from a GenderChecker database and publicly available online information. Proportions of publications by genders of the first and last authors and publications by year were assessed using chi-square tests. Distributions of H-indices and self-citations for first and last authors were compared by gender using Wilcoxon rank sum tests. Associations between citation count and first and last author gender were assessed expressing citations as a continuous (linear regression) or binary (log binomial regression) outcome to produce b estimates and relative risks, respectively, with 95% confidence intervals. The cut-point to define the binary outcome was determined through an optimal cut-point analysis. Self-citations were excluded, and results are presented unadjusted and adjusted for journal, publication year, publication type, first author country, last author country, and number of coauthors.RESULTS: A total of 4,765 articles were assessed, 2,583 from Fertility and Sterility and 2,182 from Human Reproduction. First authors were more likely to be female than male (56.1%) and senior authors were more likely to be male (63.3%). The proportion of articles authored by females increased between 2008 and 2017 (47.6 to 60.1% for first authors, 27.8 to 41.4% for senior authors; p < 0.0001 for each). H-indices stratified by gender demonstrated that men had higher H-indices compared to women (first author median 14 versus 9, p < 0.0001; senior author median 29 vs 23, p < 0.0001). Male first and senior authors were more likely than females to self-cite (p ¼ 0.015 and 0.046, respectively). After adjusting for covariates, female last authors averaged approximately one less citation than males overall. Using a cut-point of 62 (90%ile) to define a high number of citations, after adjustment, female senior authors were 24% less likely than male last authors to be in the 90 th percentile of citations (RR¼0.76, 95% CI 0.62, 0.92), and 2.5% less likely on the absolute scale (14% of females vs 16% of males). First author gender was not meaningfully associated with citation count.CONCLUSIONS: In the publications reviewed, male gender was associated with higher H-indices and male last authors had a 30% greater probability of achieving the highest 10% of citation counts compared to female last authors.IMPACT STATEMENT: Compared with prior literature, there is increased representation of women authoring reproductive medicine publications. However, males continue to be cited more and have higher H-indices, indicating a potential gender dis...
Background: As delayed family building is common among physicians, the goal of this study was to evaluate childbearing plans, anxiety related to future fertility, and interest in fertility education among medical students.Methods: An electronic REDCap survey was distributed using social media and group messaging applications to medical students enrolled in medical schools across the United States. Answers were collected, and analysis of the descriptive statistics was performed.Results: The survey was completed by 175 participants, 72% of which were female (assigned at birth). The mean (± SD) age of participants was 24.9 ± 1.9 years. Of all participants, 78.3% desire to have children and 65.1% of these individuals plan to delay childbearing. On average, the planned age of first pregnancy is 31.0 ± 2.3 years. “Lack of time” was the greatest influence on decision regarding timing of childbearing. Of all respondents, 58.9% reported at least some anxiety related to future fertility. When females and males were compared, significantly more females (73.8%) versus males (20.4%) reported worrying about future fertility (p<0.001). Participants reported that greater knowledge about infertility and potential treatments would help ease fertility related anxiety, and 66.9% of respondents showed interest in learning about how things such as age and lifestyle can impact fertility, preferably through medical curricula, videos, and podcasts. Conclusion: A majority of the medical students in this cohort intend to have children and most plan to delay childbearing. A large percentage of female medical students reported anxiety related to future fertility, but many students showed interest in receiving fertility education. This study highlights an opportunity for medical school educators to incorporate targeted fertility education into their curriculum with the intention of decreasing anxiety and improving future reproductive success.
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